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EMR Selection Time, Mobile EMR, and Difficult EMR Selection

Posted on May 19, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.


A prudent investment is an understatement. The very best use of your time in an EMR implementation is in the selection process. Although, I’ve also seen some clinics go too far and run into the issue called “paradox of choice.”


Mobile EMR has always been a wonderful idea, but how many are really using their EMR on a mobile device. Let’s also not confuse mobile EMR with remote EMR. Certainly many doctors are using the same EMR from multiple clinics. That’s common and beautiful. However, far fewer are using their EMR on a mobile device. The most common response I get from doctors about a mobile EMR is “I can access my EMR on a mobile device, but the experience is terrible.” I expect this will dramatically change over the next 3-5 years, but won’t likely be the full EMR. Instead, I think it will be a really focused set of EMR functions on the mobile device. I’m not sure anyone has nailed that experience yet. Although, a lot of EMR vendors are working on it.


Everyone that’s read this site for a while knows how much I love analogies. Both of these are pretty spot on. The root canal is necessary and can relieve a lot of long term pain, but it’s no fun going through the process. Buying a car is hard because there are so many choices and so many details that it’s hard to know what really differentiates the complex item you want to buy.

The False Economies of EMR

Posted on January 2, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In my recent look around the EMR twittersphere on EMR & EHR, I briefly commented on the challenges of choosing the wrong EMR and EMR Switching. Dan Haley from athenaHealth asked for some deeper clarification of my comment, “I’d say the biggest driver of EMR switching is thanks to the EHR incentive money and meaningful use.”

Here was my response:

I think there are a whole list of things in the HITECH act which encourage and promote the use of outdated technologies. I’m sure this is something you agree with and know all about as well.

My core argument has been, sure we’re seeing an increase in EHR adoption. However, what if the EHR incentive money is incentivizing doctors to adopt the wrong EHR. By wrong EHR I mean one that they don’t like, that can’t adapt to changing technology, that can’t support the future Smart EMR requirements that are bound to come, that kill a physician’s workflow, that cause a doctor to not want to be a doctor, etc.

I think we may be headed this direction and the number of doctors switching EHR software is a decent example of why this is the case. I’m sure that some would argue that meaningful use is driving people to switch EHR software and that the switch we’re seeing happening is from EHR software that isn’t highly functional to EHR software that is highly functional.

While this argument is true in some cases, there are just as many cases which illustrate that the EHR switching was because their first MU EHR was such a terrible experience that they had to switch EHR. Plus, we’re just at the start of this. Many are painfully grinding through the day to day with an EHR they hate. Wait until that explodes.

Even worse is those clinics that are switching EHR for the sake of EHR incentive money and go from an EHR they enjoy to one they hate. Add in the many doctors who are stuck using an EHR that was selected by some large company who didn’t worry too much about the physician needs and we’re in for a crazy next couple years.

Hopefully this gives you a better idea where my comment was coming from. Needless to say, I’m not sure that HITECH has been a benefit to doctors. The short term numbers might look good, but it might have just created some painful underlying difficulties going forward.

With all of this said, there are some beautiful EHRs out there that make doctors lives better. I’m pro-EHR when it’s done right. I just don’t see meaningful use and EHR incentive promoting the right EHR adoption methods.

This provided some interesting background for a conversation I had recently with a doctor. He told me, “It seems like there are a number of false economies driving EMR adoption.

I think meaningful use and EHR incentive money driving EHR adoption is a false economy. This doctor described to me how many of his colleagues weren’t using the EHR that they wanted, but instead were using an EHR that they “had” to use. What are some of the forced requirements for EHR that create these false economies besides meaningful use and EHR incentive money?

Another False EMR economy is around HIE connections. Many doctors can’t select the EHR they want to use and fits their workflows best because their local HIE may or may not choose to support a connection with that EHR. So, the doctor opts for an EHR that does connect with the local HIE even though it wasn’t their EHR choice.

Hospital Connections is another false economy. Similar to an HIE, many doctors will opt for what they consider to be a less than desirable EHR because it’s the one that works with their local hospitals.

I’m not trying to pretend that doctors should be the end all be all in EHR selection. A physician can think one EHR is the best and not realize until after using it that another EHR would have been better. Sometimes you think you have a great EHR until you actually use another one and realize what you’re missing. However, the easiest recipe for disaster with EHR is for a doctor to hate using an EHR. As I mention above, it will not end well and will drive the future EMR switching that I’ve predicted.

EHR Mouseclicks, #HIT100 Interview, EMR and Doctor-Patient Relationships, and Sleep Rate: Around Healthcare Scene

Posted on July 29, 2012 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

I apologize for not having a weekly round-up last week — my family and I were in Southern Colorado, and while the owner of the lodge we were staying at said there was Internet available, that didn’t prove to be completely true. So for the next two weeks, these posts will have a combination of two weeks’ of posts. There were some great posts recently, and I’d hate for anyone to miss them!

EMR and EHR

Too Many EHR Mouseclicks and Keystrokes – A Solution for EHR Vendors

Critics of EHRs claim that there are too many mouseclicks/keystrokes involved to consider it efficient. However, there are ways to overcome this complaint. If vendors would focus on making their product respond consistently, and physicians get the training they need, this hurdle can be overcome. It may take awhile for this point to be reached, but it is possible.

EMR Advocate Tops the #HIT100

The #HIT100 list aims to recognize great #HITsm and #HealthIT communities on Twitter. This week, the #1 person on the list, Linda Stotsky (@EMRAnswers), was interviewed by Jennifer Dennard. She gives her thoughts on social media and health IT, and how it’s affected her career. Stotsky also reflects on the the value that the #HIT100 list brings to the health care community.

The Intersection of EMRs and Health Information Management

While researching for a discussion she was going to moderate on the exchange of personal health information with an ACO at Healthport’s first HIM Educational Summit, Jennifer Dennard stumbled upon some interesting information. This post contains some of her thoughts, and includes a list of the top 10 trends impacting HIM in 2016. At the conclusion of her article, she asks questions concerning Meaningful Use and the relationship HIM professionals have with EMR counterparts.

Happy EMR Doctor

How an EMR Gets in the Way of Doctor-Patient Relationships

While happy with his current EMR, Dr. Michael West talks about the “darkside” of EMRs. He says that he has to pay more attention to his computer than maintaining eye contact with his patients, but this is a problem that will be difficult to resolve. Although he could just jot notes down and update the EMR later, he feels this would be more time consuming and less accurate. Is there are a solution to the barrier created between doctors and patients when an EMR is used?

Smart Phone Health Care

SleepRate: Improves Your Sleep by Monitoring Your Heart

Everyone has trouble sleeping every now and then. Unfortunately, it’s not always easy to figure out why. SleepRate, a cloud based mobile service, may be the solution. This service tracks and analyzes the users sleep patterns, and, from that information, gives suggestions on how to improve sleep. It does this by monitoring your heart using a ECG.

App Helps Potential Skin Care Victims Track Moles

1 in 5 Americans will be diagnosed with skin cancer in their life. With a chance this high of getting this terrible disease, it’s more important than ever to monitor moles and other skin lesions. An app created by the University of Michigan Health System, UMSkinCheck, makes that monitoring easier. The app sends reminders about skin checks, and allows the user

EMR Thoughts
Digital Health Takes Off in 2012

Digital Health is growing more and more. Rock Health Weekly reported that there is 73 percent more funding for it this year than at this time last year. The yearly funding report by Rock Health Weekly was recently released, and there were several interesting findings in it. Digital Health isn’t going anywhere.

Hospital EMR and EHR

The Meaningful Use Song (To The Tune of “Modern Major General”)

If you need a little pick-me up, or a smile to end your week, don’t miss this video. The “Meaningful Use Song” includes commentary on MU, written by Peggy Polaneczky, MD, to a catch tune.

From The Horse’s Mouth: What Scribes Are For

Ever wonder what a scribe does, and if they are really even needed? This post includes quotes from Scott Hagood, the director of business development for PhysAssist Scribes. This is a great position for pre-med students, and with the growth of EMR, the field for scribes continues to develop and expand as well.

Making the Case for EMR VARs

Posted on May 15, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In the comments of a post by Dr. Gregg, someone made a really interesting case for going with an EMR VAR instead of the EMR vendor itself. Of course, this commenter was named “EMRVAR” which probably means they come from a VAR. So, you have to take these comments with a grain of salt, but their comments are worth considering. Here’s the case they made for VARs.

My Advice: Seek out a VAR – Value Added Reseller that cares more about you and your practice then any BIG NAME EMR CORPORATION that only cares about its stock valuation on any given day.

VARS

A VAR is an advocate for your practice – a Var’s many installs weigh more heavily than any one customer that the BIG EMR Corp has.

A VAR deploys technology from several vendors and adapts these products and services to its customer specific needs

A VAR partners with several product manufacturers and service providers. Though partnerships are formed, it is important to realize that a VAR is an independently owned and operated business that is not bound by any one corporation products, services and policies.

A VAR is often located locally to the communities it serves

The VAR model is important in healthcare and the above comments state a pretty good case for the EMR VAR. I find it interesting that in many respects this is the case that small EHR vendors make as well.

What has been your experience with EMR VARs?

EHSD – EHR Hunt Stress Disorder

Posted on May 10, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Dr. Gregg wrote an interesting post recently about what he called EHSD (EHR Hunt Stress Disorder). He does such a great job defining the funk, I’ll let his words speak for themselves.

Since I first broke the news about Allscripts’ sunsetting of my current EHR (Peak Practice) about a year and a half ago, I have developed a severe case of a newly defined malady: EHR Hunt Stress Disorder (EHSD). I am worn down, drug out, and generally pooped. I can’t figure anymore re: local host versus cloud versus disruptor / innovator versus corporate clout versus Quippe-able versus app-able versus templates versus NLP versus digital pens versus etc., etc., etc. I just can’t. I’m done.

I have seen a slew of systems — some great, some not so much. I’ve seen apps and clouds and cool tech. I’ve even had some had offers to work with some vendors. But, in trying to decide, I think I have run headlong into The Paradox of Choice wall. Too many options have led me to the paralyzingly dissatisfactional funk of EHSD. Can’t find that “just right” one.

I’ve seen this so many times. Sometimes it goes to outrageous extremes that you almost have to just laugh at the situation. I think the core of the problem is the 600+ EHR companies that are all vying for the physician’s attention. It’s an incredible challenge for physicians to sift through all the EHR noise.

One thing that I don’t think many people want to admit is that every practice could probably select a dozen or more different EHR software and be quite satisfied. Each of those dozen EHR software would have their own intricacies, annoyances and benefits, but they all would deliver some benefit to the practice. On the opposite end, there are at least some clinics who could select any of the 600 EHR vendors and have a terrible experience. Luckily, I believe this is the minority of clinics. Most clinics I know could find benefit from any 1 of a dozen EHR.

The challenge is that the dozen EHR that could provide benefit to a practice is different for every practice. The list of good EHR for a pediatric practice is different than for a OB/GYN or Family Practice Doc. The list of good EHR is different for a solo practice versus a large group practice or multi specialty group. The list of good EHR could be different for someone in California versus Ohio. You get the idea.

My best suggestion I first gave back in 2006 when I started blogging about EMR (The EHR term wasn’t in use back then). It is to quickly narrow your EHR selection to 5 EHR vendors. This will let you focus on 5 EHR and study them in depth. This doesn’t mean that you HAVE to select one of those 5 EHR. You can always add more later if you’re not satisfied with your first 5 EHR, but it gives you something manageable.

Just remember that the goal is to find an EHR that benefits your practice, not finding the perfect EHR. Setting reasonable expectations is a key to avoiding EHSD.

Great Advice – Check Your EHR Bill

Posted on January 10, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In a post done in 2009 that’s still getting comments, Diane G. offered some interesting commentary that I think is fair warning for those purchasing an EHR (names removed since it could apply to a lot of EHR vendors):

We use Software A for our EMR, but Company A provided the equipment and installation quote for Software A and I can tell you, you’ll want to look at EVERY line they bill to your company. We have been billed for equipment that we never received and interfacing that was never launched. I have spent hours explaining to them what services they have billed us but didn’t provide. I am extremely grateful that we did not purchase their EMR and/or Practice Management product!!

Definitely a good warning for all purchases, but applies to EMR software as well. A number of EHR software companies have really simplified the way they bill and so this is less of a problem with those EHR vendors. However, many EHR vendors still try to pilfer doctors for the extras which can often add up to more than the core product. It’s ugly and unfortunate since it leaves a bad taste in doctors mouths.

Along these same lines is making sure your EHR contract is sound. There’s a whole section on EHR contracts in my EHR Selection e-Book that is worth looking at if you’re going through the EHR process.

Meaningful EHR Customization

Posted on December 7, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Curt Rosinski offered some really good advice on a previous meaningful use post for those doctors who are evaluating EHR software and the customization features that they offer:

The thing all potential consumers should keep in mind when buying an EHR, EMR or any medical management software is this; the more out-of-the-box the product is, the less customization the product is capable of. Customization in this case being meaningful customization, not screen color or placement of toolbar.

I’m not sure I agree completely that the more out-of-the box the product is, the less customization will be available. This could be the case, but EHR vendors can make it so you can customize everything in the EHR while still preserving a great out-of-the-box EHR experience.

However, the second comment was even more interesting to me. I’m always amazed how some people evaluating an EHR get so annoyed by the color of a window or get so enamored by the size of the font. I’m not saying that the color of the window and size of the font aren’t important. They can be really important in improving the usability of the software. However, if those things are so important to the usability of the system, then they shouldn’t likely make those things part of the customization preference package.

The idea of meaningful EHR customizations is a good one. Look for the EHR that does a great job balancing the out-of-the box EHR implementation experience while still making lots of customizations possible, because you can be sure that 6 months into your EMR implementation you’ll be ready to look at ways to really maximize the use of your EHR.

HITR – Health Information Technology Research Hub and Social Network

Posted on November 15, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I imagine that many of you have seen some people talking about HITR around the web. It’s a website backed by the people at Porter Research and Billian’s HealthData. I know that I first saw it a few months ago and wasn’t quite sure I understood what they were trying to do. I couldn’t tell if they were trying to be Sermo, a private healthcare IT social network, or something new. The lack of clear vision for me meant I set it to the side.

While attending AHIMA this year I had the chance to spend quite a bit of time with a number of different people from Billian’s HealthData and Porter Research. We had a great time talking about all sorts of things, but they of course told me that I should look more at their new HITR product. I told them I’d take a look not knowing what to really expect.

A week or so ago, Jennifer Dennard set up a demo of HITR for me. While still a nascent product, I was intrigued how they used their knowledge and experience in healthcare research and embedded it so fully in the product. I guess I could have and should have assumed as much, but I was reasonably impressed with the idea of having a hub for healthcare IT research. I know how much I and other IT people love our data.

One interesting thing about HITR is the give to get model that they’ve set up. Basically they’ve arranged it so you give your feedback on your products to get access to other information and research from your peers. I imagine they’ll be adjusting this model over time, but it kind of reminds me of the open source model where everyone contributes a little bit and everyone benefits from the other people’s efforts.

The real challenge that HITR faces is just making sure they get enough people involved and participating to make the information they collect valuable. Plus, they have to get enough people and the right people on board. I’m not sure how scientific the results will be considering it’s a basically self selected example. I can’t remember if they include qualitative results along with the quantitative, but that could be really helpful even if the results aren’t scientifically correct on the quantitative side.

One other concept that they said they were exploring with HITR is the idea of getting connected with referral sites for a healthcare IT product that you’re considering. I REALLY love this idea. In my e-Book on EMR selection I recommend finding some referral sites and visiting them to get a feel for that EHR software in practice and to talk with a doctor who actually uses that EHR software day in and day out. The problem is that if you ask the EMR company for some referral sites they’ll give you a bias list. I suggest in the book to ask for their entire client list. However, I think using HITR could be another interesting way to find a referral site outside of the EMR vendors’ pre-groomed list.

I asked Jennifer Dennard to send me a list of some of the other benefits of using HITR. This should also give you a decent feel for what they’re working on with HITR.

I’d list the benefits for everyone as:

  • Ability to connect with peers
  • Blogs
  • Groups
  • Discussions
  • Job boards

Benefits to providers that take surveys would include:

  • Ability to gauge how your employees evaluate the systems you’ve put in place at your facilities
  • Ability to see how those same systems are rated by your colleagues at peer institutions
  • Ability to start a more in-depth dialogue with HITR connections about HIT systems you may be considering for your facility, and their experiences with those same systems
  • Ability to influence future HIT product development

Benefits to vendors include:

  • Ability to view how their systems are evaluated by their customers
  • Ability to correspond with providers for product management/development purposes
  • In the near future, vendors will be able to sponsor surveys through HITR to deploy to their chosen audiences – customers, prospects, etc.

If you have a chance to sign up for HITR, I’d love to hear your thoughts and experience. Like I said, it’s a new site, but has some interesting possibilities if they execute it right.

Common EHR Implementation Issue – EMR Upgrade Problems

Posted on September 29, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’m really excited that this Common EHR implementation issues series has been so popular. If you missed it, you can see the previous posts in the series: Unexpected EHR Expenses, EHR Performance Issues, a little follow up to avoiding the EHR performance issues altogether, and inadequate EHR templates.

This weeks common EHR implementation issue is: EMR Upgrade Problems

I’d like to categorize this EHR implementation issue into two areas. One is upgrading to an EHR from an old legacy EHR and/or PMS. The second is upgrading your existing EHR that’s just outdated. I’ll take them in reverse order.

Upgrade of Existing Outdated EHR
In this world of your web browser and operating system auto updating at regular intervals it’s sometimes hard to remember that not all software does that. In fact, it turns out that most software doesn’t auto update (often for good reason). Of course, this problem doesn’t apply to a SaaS based EHR software since those updates are applied whether you like it or not. The nice part is that the SaaS EHR updates appear to the user to just happen automatically with little to no intervention on their part. Of course, we’ll save what happens when a SaaS EHR update causes you problems for another post. In the client server world of EHR (or hybrid EHR as some like to call themselves when they’re web based on an in house server) you will have to deal with updating your EHR.

I think with rare exception, it’s a huge mistake to not keep your EHR software up to date (goes for most other software as well). I’m not suggesting that even client server software should auto update. Considering the deployment and upgrade model of most EHR software, it’s almost essential to review the new feature list before doing an update to ensure that the update won’t cause you unnecessary heartache. Understanding the changes that will happen with the EHR Upgrade will let you warn your users about it so that they don’t come running into your office after the upgrade wondering why their favorite feature was changed.

What’s the problem with not upgrading? Many might just think that they don’t need to update their EHR software since they don’t want/need the extra features that are part of the upgrade. This is a bad strategy for a couple reasons. First, there are often security fixes that are part of the EHR upgrade that you’ll be missing out on if you don’t upgrade. Second, a bunch of relatively minor updates is much better on a clinic than one massive one that requires a ton of change. Third, when a future update comes that has a feature you do want, it’s not always pretty to go through multiple upgrades at the same time. Fourth, try calling the EHR support when you’re on an old version. Most of the time they’re going to say you need to upgrade for them to appropriately support you.

One other suggestion on EMR Upgrades now that I’ve supported the idea of upgrading. Just because I suggest you upgrade to the latest version of your EHR, doesn’t mean you have to be the beta tester for the company. Do the upgrade early in the process, but not necessarily so early that you’re going to be the bug tester for the company.

Upgrading an EHR from a Legacy EHR or PMS
This situation happens most often when either a clinic decides to switch from their old hasn’t been updated legacy PMS (which might include some basic EHR features) or when a clinic decides to move off their existing EHR to a new one.

Upgrading from a legacy PMS could easily be a whole series of blog posts. Suffice it to say that the biggest challenge with the upgrade from the old legacy PMS system is often getting the data out of it. Some legacy PMS systems don’t provide that data willing. In fact, many will even charge you to get access to it. They’ve basically lost you as a customers, so they’re trying to maximize whatever revenue they can get. It’s not pretty.

Even if you can get access to the data, there’s often a lot of data manipulation that will have to occur. A common problem that’s related to this is whether you even want to get the data out of the old PMS. Far too often, the data in the old legacy system has so much junk in it, that it’s worth considering the option of starting from scratch. It’s not pretty to upload inconsistent and ugly data from a legacy system into your nice, new EHR software.

Switching from one EHR software to another is becoming more and more common. In 2-3 years I believe we’re going to see an amazing influx of EHR software switches. It will be the topic du jour. We’re already starting to see it in a number of situations: an EHR that isn’t certified, an EHR that the doctor hates, an EHR that’s gone under, an EHR that’s sold to another company, etc.

The biggest problem right now with switching EHR software is that there’s no standard for the data to be exported and imported into a new EHR company. Some of you might remember my post asking EHR vendors to consider the value of EHR data liberation. In it I describe why not only is it the right ethical thing to do, but it also can make a lot of business sense to do so. Sadly, I’ve only really seen one EHR software that has embraced the concept of really liberating the data in their EHR.

I’d love to support a movement from EHR vendors that embrace the concept of EMR data liberation. I imagine most are too afraid of giving their users an easy option to leave their EHR. It’s too bad EHR vendors are so focused on protecting their business instead of focusing everything they do on the customer experience, but I digress.

Considering the above described state of EHR data export, you can see why moving to an EHR is such an issue. It’s worth mentioning this topic before you even select an EHR. Before purchasing the EHR, ask the question, What if this EHR is terrible and I want to switch? This is water under a bridge if you’re already in a compromising position under contract with an EHR you don’t like.

Unfortunately, I don’t really have very many great suggestions for those in this position. Just some words of comfort. First, switching EHR software can actually be easier than implementing an EHR in the first place. You already have the computers and IT infrastructure. Plus, for some reason second EHR implementations have a much higher success and satisfaction rate from what I’ve seen. Second, while it’s a bitter bullet to bite, everyone that I know that’s done it wishes they’d done it earlier. Although, don’t rush into another EHR just because. Take your time to select an EHR properly if you’re going to switch, but don’t be afraid to switch based on what economists call sunk costs. Third, this is one case where it’s often good to hire someone who’s done these type of EHR switching before. They can be a big help.

Republican Candidates Healthcare Stances

Posted on September 9, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Dr. James Coffin, VP of Healthcare and Life Sciences at Dell, has a post up on the Dell Healthcare Community site that looks at the stances of the various Republican candidates for the US Presidential nomination. It’s an interesting read if you haven’t been following the republican candidates very much.

What the article doesn’t address is these candidates stance on the HITECH Act. The key here is to realize that the HITECH act isn’t part of the Affordable Care Act which every GOP candidate is saying they will repeal if they become President. So, where does that really leave the HITECH Act should a republican president be elected?

The problem is that no one really knows. Those who argue that the HITECH Act is safe often lean on the ideas that EMR and EHR has always had bipartisan support. Many often mention that the push for adoption of EHR software was started by a republican president, George W. Bush. I actually agree that both sides of the aisle want to have widespread adoption of EHR. We could certainly argue the benefits or detriments of EHR adoption, but for a relatively uninformed senate, house and president when it comes to EHR, they’re going to easily grab on to the idea that technology can improve healthcare. We may agree or disagree with this point, but I think we’d be hard pressed to find a senator that thinks we shouldn’t have EHR technology in healthcare.

The problem with the above discussion has to do with the way that EHR is being paid for. Again, this isn’t about whether the idea of paying doctors to use EHR software is right or wrong, good or bad. This is more about the political stance of the republicans and how they want government to spend money. It seems very clear to me that Republicans are going to keep sitting on their no spending/cut spending soap box. If a republican becomes President, we’re likely to see widespread cuts. Could HITECH money be a casualty of those cuts? Absolutely. Will they be a casualty? Can anyone predict what Washington will really do?

Should doctors and practices then be afraid of going after the EHR stimulus money? Well, I’ve been advising doctors and practices for the last couple years to not implement an EHR in order to get the government hand out. Those that are doing EHR for “free” government money are going to be disappointed. Not only because the money could be cut, but because sooner or later that money will be gone. So, if you’ve followed my advice, then the loss of the EHR stimulus money will be unfortunate but not too terrible.

On the other hand, those people who only did EHR because the government was waving the carrot and the stick are likely going to be quite disappointed. Particularly if the practice focused on the governments EHR requirements instead of their own individual practice needs when it comes to an EHR. Sadly, I believe there are many clinics in this boat.

I’m sure there are other Washington DC insider workings that are in play as well. Hopefully many of you will share some of what you know in the comments.

Personally, I’m still fairly confident that the EHR stimulus money will play itself out. I’ll be a little surprised if indeed it does get cut. I think republicans will have larger fish to fry. However, there’s certainly that possibility, so doctors should take this into account when they’re selecting and implementing an EHR.